The overarching goal of this revised NRSA application is to provide a high quality mentored training experience for those future clinical cardiovascular researchers who have the potential to become the thought leaders of the next generation. The proposed training program will allow us to attract the best post-doctoral fellows into clinical research and ensure a high rate of retention of these fellows in academics after completion of training. By achieving the goal of the program, we will address the national priority of developing academic clinical researchers who can fill vital roles along the gamut of research priorities from bench to bedside, and include translational researchers as well as clinical trialists and outcomes researchers. The three objectives of this NRSA training program in clinical cardiovascular research are to provide trainees with: 1) didactic training in the methods of clinical research, 2) a mentored research experience, and 3) training and experience in "survival skills" required for a successful academic career. Trainees will spend at least 2 years in this program and devote 100% effort to the program while they are in it. We are requesting 6 trainee slots at the post-doctoral level. Formal training of participating mentors on the essentials of good mentoring will be a major feature of our program. Interdisciplinary co-mentoring will be encouraged. Twenty-one faculty representing 5 Departments at Duke (Medicine, Surgery, Anesthesiology, Pediatrics, Behavioral Medicine/Psychiatry) will participate as mentors in this program. They are organized into three general research tracks: translational (patient-oriented), clinical trials, and outcomes. These three tracks will be distinguished by the program of didactic course work chosen and the customized mentored research program created for each trainee. During the course of each fellowship, several methods will be used to monitor progress, including quarterly meetings for each fellow with the Program Director. Outcomes expected from each fellow accepted into this NRSA program that will be used to assess progress will include presentations at Duke research conferences and at national meetings, peer-reviewed publications, and at least one grant application to support the trainee's post-fellowship research. Particular emphasis will be given by the Program Director and faculty to assisting each fellow to obtain a post-fellowship faculty position in academics that will allow continuation of their research work. Program graduates will also be monitored with annual contacts to ensure continued success and establishment of a stable academic career. The proposed NRSA program will organize the abundant resources available at Duke for clinical research into a focused and efficient program for training the clinical cardiovascular thought leaders of the future.